Malcolm (Mac) A. Holliday, MD (2014)

January 12, 1924 – March 26, 2014
Obituary

Malcolm Holliday,” Mac”, as he was known, was a major figure in pediatric nephrology from its inception to the end of the 20th Century. His early research contributed greatly to our understanding of fluid and electrolyte management, and later his work was central to our understanding of growth failure in children with chronic kidney disease.

Mac’s first foray into the medical literature was as a 3 year old patient when he had a kidney removed, secondary to chronic pyelonephritis. This operation was unusual at the time and the case was published in the Virginia Medical Journal. Years later, while serving as a consultant to the MDRD study which looked at the effect of dietary protein intake on the progression of renal disease, he was asked by eminent nephrologist whether he would become a vegetarian if he had only one kidney. As relayed by Mac, he lifted his fork with steak attached and noted with a smile, that in fact; he did have only a single kidney…
Mac was an excellent student, graduating high school and entering college at 16 and entering medical school, mid-World War II, at age 19. During the war years, medical school was shortened to three years and he graduated Alpha Omega Alpha 3 years later. On graduation day, he married Mildred Wiant, his love and constant companion for the next 63 years.

Mac’s early training was peripatetic; he interned at Boston Children’s hospital, left Boston a year later to work as an assistant resident at Vanderbilt, and then returned to Boston to work as a resident and research fellow in the laboratory of Dr. James Gamble supervised by Dr. William Wallace. Two years later he moved to New Haven where he worked under another great physiologist, Dr. Daniel Darrow. While working in Dr. Gamble’s lab, Mac and Dr. Wallace built one of the earliest flame photometers, which allowed them to determine sodium and potassium concentrations much more rapidly than by previous methods. Major questions at that time dealt with the ionic composition of body fluid compartments and their defense in the face of major physiologic perturbations. Mac’s early papers demonstrate the collaborative spirit that marked his work and he published multiple papers in with other later luminaries such as Robert Winters, Ernest Cotlove, Lou Welt, Jean Oliver and Robert Schwartz.

Mac’s first academic position was at Indiana University where in 1957, in collaboration with Dr. William Segar, they published perhaps their most widely known paper, “The maintenance need for water in parenteral fluid therapy.” While the data utilized had been published previously, this paper was original in its comprehensive synthesis of energy and fluid requirements throughout the pediatric age range. They derived a formula for maintenance energy and fluid requirements, “100/50/20,” which has stood the test of time and is still used by all who care for children. The concept behind the paper, the integration of whole body physiology, would be a hallmark of Mac’s approach throughout his career.

In 1956 he was recruited by the University of Pittsburgh to head their nephrology section. While there, he was granted a prestigious Career Research Investigator Award. These awards were United States Public Health Service lifetime research awards, which are no longer available, were granted to individual investigators so long as they remained at their original institution. While in Pittsburgh, with summers spent a the Brookhaven Laboratory, Mac’s interest continued to be in the field of fluid and electrolyte therapy; publishing papers in journals as diverse as Pediatrics and Journal of Pediatrics, Journal of Experimental Medicine, Nature and American Journal of Physiology.

In 1963 Mac, Millie and their 5 children moved to the West Coast when he accepted the position of Physician-In-Chief and Head of Research at Oakland Children’s Hospital. Forward looking as always, he worked hard to affect a merger between Oakland Children’s Hospital with the University of California, but was unsuccessful. Several years later he was asked to take over as Chief of Pediatric Nephrology at the University of California, San Francisco, a position he held for the next 27 years. There he turned his attention to the physiologic problems associated with chronic kidney disease, particularly the growth failure seen in children with this condition. In a string of papers and presentations over the next 10-15 years he demonstrated that growth failure was associated with decreased nutritional intake and that growth could be improved with caloric supplementation. He also performed laboratory studies that demonstrated that uremia was associated with abnormalities of protein turnover; studies that were later validated and extended by multiple other investigators. While nutritional supplementation is now one of the mainstays of care, it should be remembered that at the time the concept was not widely accepted. Mac also introduced the use of standard deviation scores as the appropriate reporting method for growth parameters in children with chronic kidney disease.

Outside of the clinic and laboratory Mac was a force in the development of the pediatric nephrology itself. When the decision was made to develop Pediatric Nephrology as a formal subspecialty, Mac was one of three pediatric nephrologists asked to take the Internal Medicine nephrology board examination and then write the first pediatric board exam. Along with Martin Barrett, he took over the editorship of the principal pediatric nephrology textbook, Pediatric Nephrology and his view of integrative physiology that still informs the text today.

Active even after his retirement, Mac and Millie moved to Point Reyes where he served on the Board of Directors of the local health clinic, hiked the lovely pacific seashore, and welcomed frequent guests and colleagues. Mac’s later years were limited by progressive muscle weakness but his intellect and curiosity remained sharp up to the end. Mac published his last paper, a review of fluid therapy, in 2007 at age 83. He was an avid reader, particularly of American History and conversations with him often led to discussions of Lincoln, Jefferson and other American presidents.

During the two and a half decades that he led the nephrology program in San Francisco; his division was prominent as a center for the care of children with chronic kidney disease and a destination for a large number of trainees and visiting professors. Mac had a superb intellect and an inventive mind. He was a rigorous scientist who was always willing to reexamine accepted dogma in the face of new data.

Mac was unfailingly polite and personally quite modest. He was much more interested in the scientific quality of the work to be done rather than the credit attached to it, and was exceedingly generous with his time to both students and colleagues. Malcolm Holliday was a member of that great post-war generation of medical physiologists whose work so expanded our understanding of renal and integrative physiology. Both as a scientist and a person, he touched many of us. All who knew him mourn our loss.

Steven J. Wassner, MD
Distinguished Educator
Professor of Pediatrics, Chief Division of Pediatric Nephrology and Hypertension
Penn State Hershey Children’s Hospital
Penn State University College of Medicine

Richard Louis Siegler, MD (2014)

May 5, 1939 – March 22, 2014

Richard L. Siegler, 74, of Davis California, died peacefully at his home March 22, 2014, after a long battle with cancer. Dick pursued a career helping children, specializing in pediatric nephrology. He established the division of pediatric nephrology and the pediatric dialysis unit at the University of Utah, which continues to serve the entire Intermountain West region. For more than 30 years he shared his medical expertise, personal strength, humor, and commitment to quality with peers, patients and their families. He was recognized as one of the world’s experts in post-diarrheal hemolytic-uremic syndrome (HUS), publishing seminal articles on both short-term prognostic indicators and long-term complications of the disease. After retiring from the University of Utah he continued to contribute to the health of children through his work in Guatemala, where he was honored by the President of Guatemala at the opening of the Richard L. Siegler Pediatric Hemodialysis Center, the first such center in the country. Dick loved adventure, travel, and the outdoors, and once came to work battered and bruised, having become the oldest person to navigate the Olympic luge track in Park City, Utah. Dick was an accomplished violinist and was a member of the Wasatch Symphony Orchestra for many years. Dick was a true character in the best sense of the word, and he will be greatly missed. In lieu of flowers, his family suggests  donations to Bridge of Life, DaVita Medical Missions – Guatemala Project (www.bridgeoflifemm.org/our-missions/guatemala/).

His obituary is posted at:  http://www.legacy.com/obituaries/saltlaketribune/obituary.cfmx?n=richard-louis-siegler&pid=170366924#sthash.eO4nxP79.dpuf

Chester M. Edelmann, MD (2013)

Whether we refer to his deep-seated honesty of purpose or investment of one’s skills and efforts to produce the finest result, Chester M. Edelmann belonged to the best among us. He was born in New York City in 1930. His father was an accountant, and his mother a teacher. From one he probably inherited the compulsion for the exact, and from the other the tenacity, the determination. But his role model was his grandfather, nicknamed “Doc”; he practiced general medicine in Upper Manhattan. Chet went to Columbia College and then to Washington University in St. Louis, leaving behind his sweetheart, Norma. After the second year of medical school, he returned to New York City to finish medical school at Cornell University and get married. Set on a general pediatric practice, he jumped on the opportunity to move to the Bronx Municipal Hospital Center, the teaching hospital of the newly created Albert Einstein College of Medicine, where Henry Barnett moved from Cornell to assume the Chairmanship of the Department of Pediatrics. He became Chief Resident, and thereafter accepted a position in nephrology with Henry Barnett. A disputed topic at the time was the protein content of infants’ formulas. In a landmark article, published in the Journal of Clinical Investigation, Edelmann and his colleagues demonstrated that a high protein intake lead not only to an increase in urea and water excretion, but also to an increase in concentration capacity that almost wiped out the difference previously noted between infants and children.

In 1959, Chet was called to fulfill his patriotic duty. For the ensuing two years, he served as Staff Pediatrician at the U.S. Naval Hospital, in Portsmouth, VA. At the time of discharge, Chet reached the rank of Lieutenant Commander. It was already known at the time that values of blood pH and bicarbonate in young infants are lower than in older subjects. This improperly called “physiologic acidosis” of infancy was attributed to renal immaturity, on the assumption that the kidney cannot excrete into the urine a quantity of acid equal to that produced metabolically. The work of Robert Winters and others has shown that growth results in the gain of base, as alkaline bone salts are being laid down. These observations prompted Chester Edelmann, and his collaborators (Soriano, Boichis, Acosta, Stark and Gruskin) to study the response of infants and children to ammonium chloride acidosis. The rates of excretion of titratable acid and ammonium were somewhat different in infants and children, but net acid secretion, was not significantly different in the two groups. Thus, it was demonstrated that the ability of the infant to dispose of an acid load was adequate. When Edelmann et all determined the bicarbonate threshold in infants, they found it to be lower than in adults, at about 22 mmoles per liter. Moreover, the study of the renal threshold led to the identification of proximal renal tubular acidosis.

Armed with the tools required to study the function of discrete nephron segments, Edelmann and his co-workers published in fast succession a number of articles dealing with various aspects of developmental renal physiology or pathophysiology. This flurry of publications catapulted the Division of Pediatric Nephrology at Einstein to the top of the heap. In 1969, Chet was elected into the Society of Clinical Investigation, a distinguished fraternity almost exclusively reserved to internists. By than he was the Chief of the Division of Nephrology, an Associate Professor of Pediatrics, a member of the Society for Pediatric Research, and a recipient of an NIH Research Career Development Award. In 1972, Chet received the Mead Johnson Award conferred by the American Academy of Pediatrics. That same year, Henry Barnett became Associate Dean and, shortly thereafter, Chet Edelmann succeeded him as Chairman of the Department of Pediatrics at the Albert Einstein College of Medicine. The first nephrology treatise was edited by Maurice Strauss and Louis Welt in which Chet wrote a chapter on pediatric nephrology. It numbered 12 printed pages. Somebody in the publishing house of Little Brown apparently liked the chapter and approached Chet with the proposal to write a “small book” dedicated exclusively to pediatric nephrology. The year was 1976. At the time, Chet was chairing not only the Department, but was also a member of the NIH Medicine B Study Section, who’s Chairman he became one year later. And yet, he accepted to serve as editor of the first “large book” of pediatric nephrology. The amount of work was monumental, but so was the product. The book won the Technical and Scientific Award in the Field of Medicine from the Association of American Publishers, and became the standard of reference for those working in the field of pediatric nephrology.

In 1980, Chet left the Chairmanship to become Associate Dean. As expected, his new responsibilities have often kept him away from the Division and the Department in which he grew and which he nurtured. In the ancient world, teachers were rewarded in gold. So was Chet. At the 33rd Meeting of the New Orleans Medical Assembly he received a Rex doubloon (a Spanish gold coin no longer minted) as expression of appreciation for the lecture he gave. The American Society of Pediatric Nephrology and the Academy of Pediatrics, Section on Nephrology, honored Chet with the Founder’s and the Henry Barnett Awards, respectively. These tributes carry the sentiments of hundreds of people who have benefited from the many contributions he made to academic pediatrics and pediatric nephrology, and most importantly, to our Society.

Chet is survived by his adoring wife of 60 years, Norma, three loving children: John, Christopher, and Kathy and his granddaughter, Jessica, he is also survived by his sister, Maida Heitner, and her family. He is the son of the late Nannette Lenore Edelmann and Chester Monroe Edelmann, Sr. Chet was a true Renaissance man; a lover of languages and their usage: a concert level pianist; a faithful patron of opera, the theatre and the philharmonic. He created fine furniture, was a loyal Mets fan, and enjoyed simple beauty. He was devoted to his wife and family, his patients, his church, science, his community and his country. He believed in excellence, honesty, integrity and above all, compassion. Chet was a rare man, contemplative, yet effective, who quietly found success in the improved health of his patients, in the happiness of his children and in the achievement of his students and colleagues. Chet touched the lives of countless people in many countries worldwide and will be missed by all, but primarily by his wife and children.

Ellin Lieberman, MD

Dear Friends:

Dr. Harry Lieberman, the husband of Dr. Ellin Lieberman, informed me that Ellin passed away peacefully after a long illness in South Pasadena,California. The older generation of pediatric nephrologists, such as myself,knew Ellin as a teacher, writer of one of the first pediatric nephrology textbooks, and a compassionate social activist with a global view.

On a personal note, I was contacted by Ellin soon after hurricane Katrina. She and Harry had raised funds in their community to help the children with ESRD and chronic kidney disease in the New Orleans area. Many of these families had lost their homes and material possessions and have not yet recovered. Ellin and Harry’s yearly fundraising has since continued and has, for instance, enabled us to send disadvantaged kids with kidney disease to summer camp. I am told by Harry that Ellin’s request was for the fundraising to continue after her passing and she had asked donations in her memory to be made to the two causes listed below.

The pediatric nephrology community will miss Ellin.

Matti Vehaskari, MD, PhD
Professor of Pediatrics
Children’s Hospital and LSU Health Sciences Center
New Orleans

Ellin requested that donations in her memory be made to:
Ellin Lieberman Scholarship Fund
Mail to: Pasadena Community Foundation
260 S. Los Robles Ave, Suite 119
Pasadena, CA 91101
Or
National Kidney Foundation of Louisiana ’for Childrens Hospital Renal Unit’
Mail to: NKF of Louisiana
8200 Hampson St., Suite 425
New Orleans, LA 70118

Bruce Tune, MD (2011)

Bruce Tune, MD, who founded the Division of Pediatric Nephrology at the Stanford University School of Medicine, died June 25 at his home in Palo Alto of complications of Parkinson’s disease. He was 71.

Tune arrived at Stanford as an undergraduate and stayed nearly his entire career, playing many leadership roles at the School of Medicine. Between 1991 and 1993, he was acting chair of the Department of Pediatrics. In the early 1990s, Tune was instrumental in launching the pediatric kidney transplant program at Lucile Packard Children’s Hospital, which is now among the most successful organ transplant programs in the world. He was known for compassion and dedication to his patients, gravely ill children suffering from a wide variety of kidney diseases.

“He was the epitome of a true bedside doctor,” said Oscar Salvatierra, MD, the surgeon Tune helped recruit to Packard Children’s to start the kidney transplant program. “He would spend whatever time was necessary with a patient, and especially with patients’ parents, to make sure they were well-informed. He endeared himself to the families because, in tough situations, he was there for them.”

Tune single-handedly ran the Division of Pediatric Nephrology for many years, recalled Packard Children’s neonatologist Philip Sunshine, MD, who knew Tune well. “He took care of all those kids himself,” Sunshine said. When Tune was himself hospitalized for a serious respiratory infection in the 1970s, he ran the division from his hospital bed while he recovered, Sunshine said.

Tune was born Aug. 26, 1939, in New York City. His family moved to Los Angeles when he was a small child. Tune came to Palo Alto to attend Stanford, earning his bachelor’s degree and then graduating from the School of Medicine in 1965. After an internship at Strong Memorial Hospital in Rochester, N.Y., and a residency in pediatrics at Stanford, Tune moved to Washington, D.C. in 1967 to work at the National Institutes of Health. There he met Nancy Doolittle, who soon became his wife. After their marriage in 1969, the couple returned to California so that Tune could assume the position of chief resident in pediatrics at Stanford. A faculty appointment soon followed.

As a faculty member at the School of Medicine, Tune was known for his teaching skills. Tune’s departmental colleagues honored him for several years with the Bruce Tune Award, established in the 1970s for the house officer who had made the best diagnosis during the previous year.

In addition to his enthusiasm for clinical care, Tune enjoyed the scientific discovery process. “I knew Bruce as an astoundingly bright scientific physician, one who could get to the central aspect of both science and disease with a few insightful questions and observations,” said his longtime colleague and close friend Irving Weissman, MD, professor of pathology and of developmental biology.

Away from his job, Tune enjoyed spending time with his family, including daughter Sara, now of Toronto, and son Steve, now of Portland, Ore. Tune was a skilled photographer; he enjoyed music, and he and Nancy grew prize-winning roses at their Palo Alto home.

“I first met Bruce when he recruited me to come to Stanford in 1997,” said Steve Alexander, MD, Stanford’s current Pediatric Nephrology Division Chief. “By that time he had been ill with Parkinson’s for almost a decade, and the disease had begun to take its toll.” Despite declining health, Tune continued to see patients in clinic every week and participated in conferences and meetings for another two years.

“I will remember Bruce as a gentle soul who had a kind word for everyone,” concluded Alexander. ” His soft-spoken advice seemed always to ring true. He was a gifted clinical pediatric nephrologist who understood the course and management of childhood nephrosis better than anyone I have known.”

Throughout his career, Tune always wanted to help others succeed, added Salvatierra. “He was there for everyone who needed him — patients, parents, medical students and residents, the Department of Pediatrics when they needed an acting chair. Professionally, his heart and soul was all Stanford.”

In addition to his wife, two children and grandchild, Tune is survived by his mother, Sylvia Newman Tune of Orange, Calif. The family asked that anyone wishing to make donations in Tune’s memory consider giving to the American Parkinson Disease Association.

The Department of Pediatrics is planning a memorial service, although details are still being arranged.

Michael Linshaw, MD (2010)

Dr. Michael Linshaw died at home on December 31, 2010 after a long illness, which he faced gallantly and with equanimity, which was his style. His loving family was present throughout his illness and at his side as he passed away.

Mike was a beloved physician, and we will greatly miss him, as will his many colleagues and patients around the world.

Mike had a long and distinguished career in pediatric nephrology as a clinician, teacher, and scientist; he was a unique person. He focused his work on the human aspects of medicine, positively influencing the lives of many children and their families, mentoring numerous young doctors, and conducting research that influenced the standard of care.

Beyond medicine, Mike was an accomplished classical pianist, chess player, bird watcher, and nature photographer. Those of us who came to know him—whether as family, friend, colleague, student, patient or just fellow traveler— were often wowed by his combination of joy, knowledge, compassion, and ethics. Mike cherished and celebrated life in his kind, quiet, and humorous way, even as he was increasingly challenged by his struggle with his illness. But even as his physical situation became insoluble, he remained vibrant and generous. He always reached out, asked those who had come to see him, “how are you?” and he asked it with genuine interest and caring.

Mike received his undergraduate degree in Philosophy at Franklin and Marshall College in 1962, and his MD from Hahnemann Medical College in 1966. After an internship at Maine Medical Center, he did his residency at the University of Vermont and then Mount Sinai Hospital in NY. He did a renal fellowship at St. Christopher’s Hospital for Children in Philadelphia, and an additional fellowship in renal physiology at Cornell Medical Center in NY. Mike was first a faculty member at the University of Kansas and then at the University of Connecticut, Tufts University, and for the past ten years at Harvard Medical School and MassGeneral Hospital for Children at MGH.

The son of the late Charles and Emily Linshaw, he was predeceased by his brother, Jack, and is survived by his loving wife Diane and three sons, Charles, Andrew and David. In lieu of flowers, please send donations in his memory to the Department of Pediatrics, MassGeneral Hospital for Children, 55 Fruit Street, Boston, MA 02114-2622.

Julie Ingelfinger
Harald Jueppner
Lockie Milner

Juan Rodriguez Soriano, MD (2010)

 (1933-2010)

The pediatric nephrology community has lost one of its stars. Juan Rodríguez Soriano was born on March 5, 1933 in Barcelona were he was raised and pursued his education up to and including the medical degree. After several years of general pediatric training at the Clinical Hospital of Barcelona, he won a scholarship at Hôpital des Enfants Malades, and arrived in Paris in October 1959. There, under the chairmanship of Prof. Pierre Royer, pediatricians from anywhere in the world had the unique opportunity to take a course devoted exclusively to the diagnosis and treatment of kidney diseases in children. At the time, in the adjacent Hôpital Necker, in the department of Prof. Jean Hamburger, nephrology was being born as a specialty distinct from internal medicine. Relationships between the two services were very close, and the joint sessions of pathologic correlations, directed by Dr. Renée Habib, remained indelible in Juan’s memory.

During the ensuing years, the group of Dr. Henry L. Barnett, Chairman of Pediatrics at the Albert Einstein School of Medicine in New York, gained prominence in the field of renal pathophysiology. His student, Dr. Chester M. Edelmann, developed the Division of Pediatric Nephrology in the early 60’s, with a strong focus on the investigation of neonatal renal function. With the support of Prof Royer, Juan joined the group in January 1963 as one of its first fellows. The research performed during those years, to which Juan contributed, included the mechanisms of urinary acidification [1,2] and urinary concentration in the newborn [3], and the seminal description of proximal renal tubular acidosis [4,5].

Juan returned to Barcelona in 1967 and became Head of the Clinical Service at the Children’s Hospital Vall d’Hebron. There, he met Maria Jesus Vita, a pediatric radiologist, who became his wife and the mother of their three children. In 1970, he took charge of the Department of Pediatrics at the Hospital Universitario de Cruces, where he remained until his retirement in 2003. At de Cruces, he led a group of young pediatricians, many trained in the U.S., and promoted the training of pediatric subspecialists. His incredible breath of knowledge, teaching skills, analytical ability, and clinical expertise were recognized by all those who had the privilege to work with him. In the 70’s, 80’s and early 90’s, he continued researching and publishing on renal function tests (6-10) and various tubulopathies (11-17). From the middle of the 90’s he collaborated with Dr. Richard Lifton’s group, at Yale University, and with other investigators, in the search to identify the molecular basis of Bartter syndrome [18,19], renal tubular acidosis [20,21], familial hypomagnesemia with hypercalciuria and nephrocalcinosis[22,23],pseudohypoaldosteronism [24,25], and other genetic disorders. His scientific contributions are described in over 300 publications.

In September 1967 Juan was in Glasgow for the founding of the European Society of Pediatric Nephrology, under the chairmanship of Gavin Arneil. In December 1968 he attended the meeting of the International Society of Pediatric Nephrology in Guadalajara, Mexico, and one of the first meetings of the International Study of Kidney Disease in Children, chaired by Henry Barnett, in Puerto Vallarta. In 1973, Spanish pediatricians founded the Section of Pediatric Nephrology of the Spanish Association of Pediatrics, followed by the Spanish Pediatric Nephrology Association, of which Juan was president from 1976 to 1981. He held the Grand Cross of the Civil Order of Health, was an honorary member of the Spanish Association of Pediatrics, was councilor on the IPNA Board from 1990 to 1995, served for several years on the Editorial Board of the Spanish Annals of Pediatrics, and was a member of the Editorial Board of Pediatric Nephrology for two extended periods (1987-1992 and 1995-2002). He will be deeply missed.

Adrian Spitzer
Chester Edelmann

Nancy Hinkle Holland, MD (2010)

Died on March 7, 2010 at the age of 88

Dr. Nancy Holland was the first pediatric nephrologist in the Commonwealth of Kentucky joining the faculty of the University of Kentucky in 1964. After serving as First Lieutenant in the Army Nurse Corp at Walter Reed Hospital in Washington, D.C., she graduated from the University of Louisville School of Medicine in 1954. She completed her fellowship training under Clark D. West in 1960 at the Children’s Hospital Reseacrh Foundation in Cincinnati and remained there as an Assistant Professor (1962-64). She was appointed Professor of Pediatrics and Director of Pediatric Nephrology at the University of Kentucky in 1972 and served in those capacities until her retirement in 1988. Dr. Holland was one of the initial members of our society, serving on the committee on dialysis and transplantation (1973) an the membership committee (1977-80) which she chaired in 1979-80. She had over 50 publications related to a wide variety of topics in pediatric nephrology. She was most passionately interested in urinary tract infection and reflux nephropathy. Her clinical expertise and advocacy for her patients was clearly apparent to medical students, residents and faculty colleagues at the University of Kentucky Medical Center in Lexington.

Dr. Holland is survived by her husband of 49 years, Dr. Charles Phillip Holland, her sister Anne Hinkle Baldwin, her sister-in-law, Sally Spears Hinkle, her 7 nieces and nephews and her eighteen great-nieces and great-nephews, all of whom felt her never failing love and encouragement.